POS1306 HEALTH-RELATED QUALITY OF LIFE (HRQOL) ACROSS DIFFERENT CONNECTIVE TISSUE DISEASES (CTDS): ANALYSIS OF A MONOCENTRIC EXPERIENCE
Authors: E. Elefante, L. Gualtieri, C. Cardelli, M. DI Battista, L. Carli, A. Della Rossa, C. Tani, M. Mosca
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> patients with CTDs have a worse HRQoL compared with the general population and chronic non-rheumatic diseases. However, only few studies have compared HRQoL among CTDs that differ for age at diagnosis, type and severity of organ involvement, disease course. <h3>Objectives</h3> to analyze HRQoL and fatigue across different CTDs in a monocentric cohort. <h3>Methods</h3> a cross-sectional study that enrolls consecutive adult patients with a diagnosis of Systemic Lupus Erythematosus (SLE), Systemic Sclerosis (SSc) and Idiopathic Inflammatory Myopathies (IIM), regularly followed at the Rheumatology Unit of Pisa. For each patient, demographics, treatment, clinical and laboratory data were collected. At enrollment, each patient completed the SF-36 for HRQoL and the FACIT for fatigue. <h3>Results</h3> we enrolled 490 CTD patients: 255 (52%) SLE, 150 (30.6%) SSc, and 85 (17.3%) IIM. The majority were female (85.7%) and of Caucasian ethnicity (97.5%). At enrollment, patients with SLE were significantly younger (mean age: 44.6 ±12.7 years for SLE, 62.6 ±13.6 for SSc, 65.7 ±12.4 for IIM, p&lt;0.001), with a significantly longer disease duration (14.1 ±10.1 years for SLE, 8.2 ±6.4 for SSc, 5.3 ±5.7 for IIM, p&lt;0.001) compared to the other two groups. The rate of fibromyalgia was highest in SSc (24.7% in SSc, 15.3% in SLE, 11.8% in IIM). Among SLE patients, 79 (31%) presented a mild active disease at enrollment, with skin (35/255) and hematological (32/255) manifestations being the most frequent; only 11 patients (4.3%) presented an active renal disease. Among IIM patients, 67 (78.8%) presented an active disease according to the clinician evaluation: 31 had active myositis and 29 active skin lesions. 33 patients had an Interstitial Lung Disease (ILD). Among SSc patients, 62% presented limited skin involvement; 45 patients (30%) had an ILD and 41 (27.3%) presented a scleroderma heart involvement, while 18 patients had active digital ulcers at enrollment. As far as treatment is concerned, most patients were on Hydroxychloroquine (63.5%); almost half of patients enrolled (45.7%) were on a low dose of glucocorticoids (mean daily dose 2.12 ±2.78 mg of 6-methylprednisolone), and 43.9% were on immunosuppressants. The results of the SF-36 domains are represented in Figure 1. We compared the results of questionnaires across groups. At the univariate analysis, the domains of Physical Function (PF), Role Physical (RP) and Role Emotional (RE) resulted different between groups. In particular, the IIM patients presented the lowest scores compared with the other two groups (Table 1). However, at the multiple linear regression analysis, only the PF domain confirmed to be significantly different across the three groups, after adjusting for age at enrollment and disease duration (β-0.003, [95% CI-0.005, -0.001; p&lt;0.01]). Finally, the FACIT scores were not significantly different between groups. <h3>Conclusion</h3> in our monocentric cohort of patients with CTDs, there were no clear differences in HRQoL driven by diagnosis, except for the physical function domain which appeared more impaired in myositis patients. HRQoL appears as an independent domain of patients' health status, only marginally influenced by the clinical characteristics of the disease. This underlines the importance for clinicians managing patients with complex autoimmune diseases to develop common strategies to address and improve HRQoL, parallel to the clinical management of the disease. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.